Provider Demographics
NPI:1821714718
Name:A MOUNTAIN OF HOPE INC
Entity Type:Organization
Organization Name:A MOUNTAIN OF HOPE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZING OFFICIAL AND BOARD MEMBE
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYNN
Authorized Official - Middle Name:N
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:859-333-1009
Mailing Address - Street 1:121 PROSPEROUS PL STE 4A
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1828
Mailing Address - Country:US
Mailing Address - Phone:859-333-1009
Mailing Address - Fax:
Practice Address - Street 1:121 PROSPEROUS PL STE 4A
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1828
Practice Address - Country:US
Practice Address - Phone:859-333-1009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty